Pellino G, Selvaggi F, Ghezzi G, Corona D, Riegler G, Delaini G G
Colorectal Surgery Unit, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Piazza Miraglia, 2, 80138, Naples, Italy.
Department of General and Hepatobiliary Surgery, Policlinico "G.B. Rossi", University of Verona, Verona, Italy.
Tech Coloproctol. 2015 Oct;19(10):639-51. doi: 10.1007/s10151-015-1368-4. Epub 2015 Sep 24.
The management of Crohn's disease (CD) requires extensive expertise. Many treatment options are available, and surgery still plays a crucial role. In recent years, many medical societies have provided surgeons and gastroenterologists dealing with CD with authoritative guidelines. However, a certain degree of variation can be observed in these papers, and application of guidelines in clinical practice should be improved. The Italian society of colorectal surgery (SICCR) promoted the project reported here, which consists of a think tank of Italian colorectal surgeons to address the surgical aspects of CD management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of CD. The management of CD is, by necessity, patient-tailored, and it is based on clinical data and surgeon's preference, but the committee was able to identify some points of major disagreement and suggested strategies to improve quality of available data and acceptance of guidelines.
克罗恩病(CD)的管理需要广泛的专业知识。有多种治疗选择,手术仍然起着关键作用。近年来,许多医学协会为处理CD的外科医生和胃肠病学家提供了权威性指南。然而,在这些文件中可以观察到一定程度的差异,并且应改进指南在临床实践中的应用。意大利结直肠外科学会(SICCR)推动了此处报告的项目,该项目由意大利结直肠外科医生组成的智囊团组成,以解决CD管理的外科方面问题。该学会成员受邀根据文献中的现有证据,就写作委员会提出的几个项目发表意见。现将结果呈现,重点关注相关要点。本文并非现有指南的替代方案;相反,它提供了SICCR外科医生对CD手术治疗态度的一个快照。CD的管理必然是针对患者量身定制的,它基于临床数据和外科医生的偏好,但委员会能够确定一些主要的分歧点,并提出了改善现有数据质量和指南接受度的策略。